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Vitamin D in Relation to Incident Sarcopenia and Changes in Muscle Parameters Among Older Adults: The KORA-Age Study

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Abstract

Effects of low serum 25OHD on age-related changes in muscle mass and function remain unclear. Our aims were to explore associations of baseline 25OHD levels with prevalent and incident sarcopenia and changes in muscle parameters, and to examine the role of parathyroid hormone (PTH) therein. Cross-sectional (n = 975) and prospective analyses (n = 702) of older adults aged 65–93 years participating in the KORA-Age study. Sarcopenia was defined using the 2010 European Working Group on Sarcopenia in Older People (EWGSOP) criteria as low muscle mass combined with low grip strength or low physical performance. Associations with baseline 25OHD were examined in multiple regression analyses. Low vitamin D status was linked to increased odds of prevalent sarcopenia. Over three years, low baseline 25OHD < 25 vs. ≥ 50 nmol/L were associated with greater loss of muscle mass and increased time for the Timed Up and Go test. The risk for developing incident sarcopenia was not significantly elevated in individuals with low baseline 25OHD but when including death as combined outcome alongside incident sarcopenia, there was a strong positive association in multivariable analysis [OR (95% CI) 3.19 (1.54–6.57) for 25OHD < 25 vs. ≥ 50 nmol/L]. There was no evidence for a PTH-mediating effect. Low baseline 25OHD levels were associated with unfavorable changes in muscle mass and physical performance, but not with incident sarcopenia. Future randomized trials are needed to assess causality and to address the issue of competing risks such as mortality in older cohorts.

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Acknowledgements

We thank all participants of the KORA-Age study for their extraordinary commitment and goodwill. The KORA study was initiated and financed by the Helmholtz Zentrum München – German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria. The KORA-Age Project was financed by the German Federal Ministry of Education and Research (BMBF FKZ 01ET0713 and 01ET1003A) as part of the ‘Health in old age’ program. RC is supported by a PhD scholarship from the ‘Studienstiftung des deutschen Volkes’. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764, Neuherberg, Germany

    Romy Conzade, Annette Peters & Barbara Thorand

  2. Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig Maximilian University of Munich, 81377, Munich, Germany

    Eva Grill

  3. Department of Geriatrics and Aging Research, University of Zurich and University Hospital Zurich, 8091, Zurich, Switzerland

    Heike A. Bischoff-Ferrari

  4. Department of Medicine IV, University Hospital, Ludwig Maximilian University of Munich, 80336, Munich, Germany

    Uta Ferrari

  5. Department of Computer Science, UiT - The Arctic University of Norway, 9037, Tromsø, Norway

    Alexander Horsch

  6. Deutsches Herzzentrum München, Technische Universität München, 80636, Munich, Germany

    Wolfgang Koenig

  7. DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80802, Munich, Germany

    Wolfgang Koenig

  8. Institute of Epidemiology and Biostatistics, University of Ulm, 89081, Ulm, Germany

    Wolfgang Koenig

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  1. Romy Conzade
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  8. Barbara Thorand
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Contributions

RC and BT conceived and designed the study. RC analyzed the data and wrote the first draft of the paper. EV, HBF and BT, as members of the PhD Thesis Committee of RC, helped in interpreting the data. All authors revised the paper critically for intellectual content and approved the final version. All authors agree to be accountable for the work and to ensure that any questions relating to the accuracy and integrity of the paper are investigated and properly resolved.

Corresponding author

Correspondence to Barbara Thorand.

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Conflicts of interest

Romy Conzade, Eva Grill, Heike A. Bischoff-Ferrari, Uta Ferrari, Alexander Horsch, Wolfgang Koenig, Annette Peters and Barbara Thorand declare that they have no conflict of interest.

Human and Animal Rights

The KORA-Age was approved by the Ethics Committee of the Bavarian Medical Association (Reference Number 08064).

Informed Consent

Written informed consent has been obtained from the participants and all investigations have been conducted according to the principles expressed in the Helsinki Declaration.

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Conzade, R., Grill, E., Bischoff-Ferrari, H.A. et al. Vitamin D in Relation to Incident Sarcopenia and Changes in Muscle Parameters Among Older Adults: The KORA-Age Study. Calcif Tissue Int 105, 173–182 (2019). https://doi.org/10.1007/s00223-019-00558-5

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